Secondary Condition Claim · VASRD 5025
Fibromyalgia Secondary to Chronic Fatigue Syndrome (CFS)
A condition caused or aggravated by an already service-connected disability can be granted its own service connection as a secondary condition under 38 CFR § 3.310. Here's how that works for Fibromyalgia when it develops after Chronic Fatigue Syndrome (CFS).
Why Fibromyalgia Is Linked to Chronic Fatigue Syndrome (CFS)
Fatigue may coexist or be confused with muscle pain syndromes.
Primary condition · VASRD 6354
Chronic Fatigue Syndrome (CFS)
CFS causes persistent fatigue not improved by rest and worsened by physical or mental activity.
Secondary condition · VASRD 5025
Fibromyalgia
Fibromyalgia is a chronic pain condition marked by widespread musculoskeletal pain and tender points, usually with fatigue, unrefreshing sleep, stiffness and cognitive fog. VA rates it under DC 5025, and the percentage turns on how much of the time the pain is present and whether medication or therapy controls it — not on how many joints are involved.
Fibromyalgia VA Rating Tiers
The VA rates Fibromyalgia the same way whether it's claimed directly or as secondary to Chronic Fatigue Syndrome (CFS) — severity of Fibromyalgia itself determines the percentage.
Example combined rating
40% Chronic Fatigue Syndrome (CFS) + 20% Fibromyalgia = 52%
The VA combines ratings with Table I of 38 CFR 4.25, not simple addition — 40% and 20% combine to 52%, not 60%. These figures are illustrative; your actual rating for each condition depends on your own evaluation.
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Evidence for a Fibromyalgia Secondary Claim
- •A rheumatologist's or primary care provider's diagnosis.
- •Documentation of tender points identified during a physical exam.
- •A symptom journal or pain log showing the pattern and frequency of flares over time.
Common questions about Fibromyalgia secondary to Chronic Fatigue Syndrome (CFS)
- Can Fibromyalgia be service-connected as secondary to Chronic Fatigue Syndrome (CFS)?
- Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. Fatigue may coexist or be confused with muscle pain syndromes. You'll need a current Fibromyalgia diagnosis and a medical nexus opinion linking it to your service-…
- What VA rating can I get for Fibromyalgia as a secondary condition?
- Fibromyalgia is rated under VASRD diagnostic code 5025 using the same criteria whether it's a direct or secondary claim: possible ratings are 40%, 20%, 10%. The rating depends on the severity of Fibromyalgia itself, not on the severity of Chronic Fatigue Syndrome (CFS).
- How does a secondary Fibromyalgia claim affect my combined VA rating?
- The VA doesn't add ratings together. Using the official combined-ratings formula (38 CFR 4.25): a 40% rating for Chronic Fatigue Syndrome (CFS) combined with a 20% rating for Fibromyalgia (example figures) produces a combined rating of 52%, not 60%. Approving Fibromyalgia as secondary still typically raises your overa…
- What evidence do I need to service-connect Fibromyalgia as secondary to Chronic Fatigue Syndrome (CFS)?
- Strong evidence for the underlying Fibromyalgia diagnosis includes: A rheumatologist's or primary care provider's diagnosis.; Documentation of tender points identified during a physical exam.; A symptom journal or pain log showing the pattern and frequency of flares over time.. For the secondary link itself, a nexus l…
Primary condition
Full Chronic Fatigue Syndrome (CFS) guide
Secondary condition
Full Fibromyalgia guide
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See how Chronic Fatigue Syndrome (CFS) and Fibromyalgia combine with the rest of your service-connected conditions using the official VA combined-ratings formula.
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